One common symptom for both boys and girls is shortness in height. Other symptoms include:
Symptoms in boys:
Lack of testicular enlargement by age 13 ½
Lack of pubic hair by age 15
Genital enlargement that takes more than five years from start to completion
Symptoms in girls:
Lack of breast development by age 13
Lack of pubic hair by age 14
Failure to menstruate by age 16
Time lag of more than five years from breast development to first period
The doctor will ask about your child’s symptoms and medical history. A physical exam will be done. An assessment of your child's milestones and growth will be done. An
of the left wrist bone may be taken. This will help to assess if bone growth is normal for your child’s age.
Depending on these results, other tests may be ordered, including:
Hormonal levels: FSH, LH, and estradiol in girls; testosterone in boys
GnRH stimulation test
of head and pituitary gland to exclude tumors or lesions
There is often no treatment for those who are healthy and just starting later than their peers. They will continue to be monitored.
For those who have a chronic underlying disease, treatment is aimed at the specific condition. Once the condition is treated, puberty often proceeds on its own.
For others treatments may include:
Sex Hormone Replacement
Sex hormones are given to those with chromosomal abnormalities. This can include Turner or Klinefelter syndrome. The hormones will help begin sexual development. Hormones may also be given to teens who are severely delayed or overly stressed by their lack of development.
This drug can increase the height in boys with constitutional delay of puberty.
Counseling may be suggested for adolescents who are struggling with the delay.
If a tumor is found in the head, the doctor may remove the tumor.
The doctor will continue to monitor your child’s height, weight, and sexual development. This will help determine if any treatment has been effective.
Most causes of delayed sexual development cannot be prevented. To help reduce the chance, make sure your child is kept as healthy as possible. This includes making sure they are eating well and getting all the nutrients they need. Make sure any underlying illness is treated.
Hero M, Wickman S, Dunkel L. Treatment with the aromatase inhibitor letrozole during adolescence increases near-final height in boys with constitutional delay of puberty.
Louis GMB, Gray LE, Jr, Marcus M, et al: Environmental factors and puberty timing: expert panel research needs.
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a